Strange History of Silicone Held Many Warning Signs

Published: January 18, 1992

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Millions of women around the world have had silicone gel breast implants and are delighted with them, and the Federal Drug Administration advises women to leave implants in place unless they are causing trouble. In fact, researchers like Dr. Kenneth McCarty of Duke University Medical Center, who has studied 3,880 women with breast implants, said today that the biggest problem most of them face is uneasiness caused by unnecessary alarm over implants. And he said some women may put off breast surgery because they fear they would not get the best reconstruction and implants.

And even researchers like Dr. Silverstein think women should be able to weigh the risks and choose breast implants if they want them. From Mortar to Tool Of Prostitutes

The outer rings of the silicon atom are just like that of carbon, the element upon which all living things are based. Silicon is also the base element in sand, and all animals confront it in small quantities daily. Scientists and science fiction writers alike have fantasized that an entire, parallel universe could be built on a silicone rather than carbon base.

But between the periodic chart and the industrial profit sheet, nature can shift shapes in surprising ways.

The commercial story of silicone began in the 1930's, when scientists at Corning Glass were looking for a caulking material to use as mortar between its fashionable glass blocks. Silicone was considered because it withstood extremes of temperature and retained its properties remarkably well.

Silicones are chains of silicon molecules with side-groups of other molecules. Silicones are versatile; the molecules can be linked up in relatively short chains, which make rather runny liquid, or into much longer chains, which are more rigid and make materials like rubber bands or solid rubber blocks.

Silicone turned out not to be a good substitute for mortar, and silicone in that form remained a laboratory curiosity until the 1950's, when it went on the market as "Silly Putty."

But scientists had taken another look at silicone in World War II when the military asked Corning Glass and Dow Chemical to seek substitutes for scarce rubber. One of the first forms of silicone developed in this effort was a liquid used as an insulator in transformers. At the end of the war, the silicone was used in transformers throughout the nation's electrical network.

The next step in the odyssey detours through the realms of sex and psychology: silicone was used to increase the breast size of Japanese prostitutes. Dr. Edward Kopf, a plastic surgeon in Las Vegas who has made a hobby of the history of silicone, said Japanese cosmetologists realized that American servicemen preferred women with larger breasts than were common among Japanese women. After experimenting with goats' milk, paraffin and a variety of other substances, they tried silicone, injecting it directly into the breast. Soon transformer fluid began disappearing from the Navy's docks in Japan, Dr. Kopf said.

American plastic surgeons began to pick up the Japanese practice, and during the 1960's and 70's, United States literature became littered with grotesque stories and pictures of women with lumpy, ulcerated breasts and scars and other problems in their abdomen, chest, arms and back from the drifting sticky bits of silicone. In a few cases in which the silicone migrated to the lungs, the result was death. Uses Flourished But Doubts Did Too

Often, the liquid silicone was mixed with other materials in hope that the resulting inflammation and scar tissue would prevent the formation and migration of lumps.

Doctors working for Dow Corning Corporation contended that problems associated with the injections arose from the other materials, and the company continued to make silicone for injection until it was made illegal, first in Nevada, where many of the worst cases were, then in California, and finally by the Food and Drug Administration.

But researchers continued to seek medical uses for silicone. In 1962, Dr. Frank Gerow and Dr. Thomas Cronin, who later joined Dow Corning, combined rubbery and liquid silicone to create a gel that was soft but firm. They wrapped this gel in a thin envelope of the rubbery silicone polymer, usually referred to as the "elastomer." This was the first silicone gel breast implant. Though the implant has been modified, the basic form is the one that was in use until the F.D.A. effectively banned the sale of silicone gel implants last week.

Many other medical products were developed from silicone, mostly from the elastomer, including tubes and valves, clips that close fallopian tubes in sterilization surgery, penile prostheses, intraocular lenses and tubing for blood oxygenators and dialysis machines.

Overall, these products worked well. But over the years there were disturbing signs that the silicone they contained could cause problems.

One study involved patients on kidney dialysis in which machines purify the patient's blood, which was pumped through silicone tubing. The researchers found that the patients were getting liver disease at an unusually high rate, and some died of it. Autopsies showed their livers had a large number of silicone particles, later shown to have come from the silicone tubing. When the tubes were replaced with another type, the problem stopped.